Predictors of thrombosis in patients treated with bevacizumab

Sparks, Jessica; Wu, Xiaoyong; Knable, Mika Kessans; Shesh, N.; Sharma, Vivek R.

doi:10.1016/j.tru.2021.100095

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…This is consistent with the higher rates of macrovascular invasion, encompassing portal vein thrombosis, observed in our overweight cohort. Sparks et al, observed BMI did not impact on rates of thrombosis in colorectal, ovarian, lung and gliblastoma multiforme cancer patients receiving bevacizumab [ 51 ]. The higher rates of thrombosis observed in our overweight cohort of HCC patients may be due to underlying liver dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Impact of body mass index in patients receiving atezolizumab plus bevacizumab for hepatocellular carcinoma

et al. 2023

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Background Atezolizumab plus bevacizumab (Atezo/Bev) is first line-treatment for unresectable hepatocellular carcinoma (HCC). Body mass index (BMI) has demonstrated predictive value for response to immunotherapy in non-HCC cancer types. Our study investigated the effect of BMI on safety and efficacy of real-life use of Atezo/Bev for unresectable HCC. Methods 191 consecutive patients from seven centres receiving Atezo/Bev were included in the retrospective study. Overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and disease control rate (DCR) defined by RECIST v1.1 were measured in overweight (BMI ≥ 25) and non-overweight (BMI < 25) patients. Treatment-related adverse events (trAEs) were evaluated. Results Patients in the overweight cohort (n = 94) had higher rates of non-alcoholic fatty liver disease (NAFLD) and lower rates of Hepatitis B compared to non-overweight cohort (n = 97). Baseline Child–Pugh class and Barcelona Clinic Liver Cancer stage were similar between cohorts, with lower rates of extrahepatic spread in the overweight group. Overweight patients had similar OS compared to non-overweight (median OS 15.1 vs. 14.9 months; p = 0.99). BMI did not influence median PFS (7.1 vs. 6.1 months; p = 0.42), ORR (27.2% vs. 22.0%; p = 0.44) and DCR (74.1% vs. 71.9%; p = 0.46). There were higher rates of atezolizumab-related fatigue (22.3% vs. 10.3%; p = 0.02) and bevacizumab-related thrombosis (8.5% vs. 2.1%; p = 0.045) in the overweight patients, but overall trAEs and treatment discontinuation were comparable between cohorts. Conclusion Atezo/Bev has comparable efficacy in overweight HCC patients, with an increase in treatment-related fatigue and thrombosis. Combination therapy is safe and efficacious to use in overweight patients, including those with underlying NAFLD.

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Section: Discussionmentioning

confidence: 99%

Impact of body mass index in patients receiving atezolizumab plus bevacizumab for hepatocellular carcinoma

et al. 2023

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“…30 A retrospective study by Sparks et al also suggested a trend of increasing TE in bevacizumab-treated patients with higher proteinuria. 31 The pathophysiology of antiangiogenic therapy-related proteinuria is not fully understood. Further studies are still required to explore the pathophysiology and the relationship between TE and proteinuria.…”

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confidence: 99%

Outcome of Thromboembolic Events and Its Influence on Survival Time of Advanced NSCLC Patients Treated with Antiangiogenic Therapy

Ou,

Liao,

Hsu

et al. 2023

CMAR

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Background: Antiangiogenetic therapy and lung cancer, per se, are associated with an increased risk of thromboembolic events (TE). We aim to evaluate the pattern and outcome of TE as well as its influence on survival time of advanced non-small cell lung cancer (NSCLC) patients receiving antiangiogenic therapy. Methods: This was a retrospective cohort study, which included advanced NSCLC patients receiving antiangiogenic therapy. All TE were confirmed by objective image studies. We disclosed the presentation and risk factors of TE and evaluated its influence on outcome. Results: A total of 427 patients were included. TE occurred in 43 patients (10.1%). Deep vein thrombosis (DVT) was the most common TE (n = 20). Up to 46.2% of DVT did not occur in the typical lower extremities. Two patients died of TE. Among patients with continuous use or reuse of antiangiogenetic therapy, 18.2% had recurrent TE events. At the occurrence of TE, 28 patients experienced progressive disease (TE with PD), while tumor status remained stable in another 15 patients (TE without PD). The post-TE survival of patients without and with PD were 8.9 months (95% CI 3.9-13.9) vs 2.2 months (95% CI 0.1-4.3), P = 0.012. As compared with patients without ), TE with PD patients experienced a significantly shorter overall survival (20.1 months [95% CI 15.5-24.6]), but TE without PD patients had comparable survival time (32.7 months [95% CI 7.4-28.1]) (P = 0006). The use of hormone analogue and proteinuria predicted the events among TE with PD group (aOR 2.79 [95% CI 1.13=6.92]; P = 0.027) and TE without PD group (aOR 4.30 [95% CI 1.13-16.42]; P = 0.033), respectively. Conclusion: Owing to the different risk factors and influences on the survival time, TE with and without PD may be two different disease entities.

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Incidence, risk factors, and outcome of advanced NSCLC patients receiving antiangiogenic therapy with thromboembolic events: a retrospective cohort study

Liao

Hsu

et al. 2022

Preprint

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Background Antiangiogenic therapy is widely used in advanced non-small cell lung cancer (NSCLC) patients. The purpose of this study was to investigate the incidence, risk factors, and outcome of advanced NSCLC patients receiving antiangiogenic therapy with thromboembolic events (TE). Methods This was a retrospective study, which included advanced NSCLC patients receiving antiangiogenic therapy from March 2013 to May 2021 at Taichung Veterans General Hospital. All TE were confirmed by objective image studies. We further categorized TE into disease-related and treatment-related according to the tumor control status when TE occurred. Results A total of 427 patients were included. The overall incidence of TE was 10.1% (n = 43); among these patients, 28 (6.6%) and 15 (3.5%) patients were categorized into disease- and treatment-related TE, respectively. Multivariate analysis suggested that the use of hormone and proteinuria independently predicted a higher TE incidence among patients with disease-related TE (adjusted odds ratio [aOR] 2.79 [95% CI 1.13 = 6.92]; P = 0.027) and treatment-related TE (aOR 4.30 [95% CI 1.13–16.42]; P = 0.033), respectively. As compared with patients without TE, disease-related TE significantly predicted a shorter median overall survival (21.6 vs. 31.4 months, adjusted hazard ratio [aHR] 1.30 [95% CI 1.05–1.61]; P = 0.017), but patients with treatment-related TE had comparable survival time (32.7 vs. 31.4 months; aHR 1.05 [95% CI 0.57–1.61]; P = 0.876). Conclusion Patients receiving antiangiogenic therapy with TE should be further differentiated whether it is treatment- or disease-related, because the two groups had different risk factors and influences on outcome.

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Predictors of thrombosis in patients treated with bevacizumab

Cited by 3 publications

References 24 publications

Impact of body mass index in patients receiving atezolizumab plus bevacizumab for hepatocellular carcinoma

Impact of body mass index in patients receiving atezolizumab plus bevacizumab for hepatocellular carcinoma

Outcome of Thromboembolic Events and Its Influence on Survival Time of Advanced NSCLC Patients Treated with Antiangiogenic Therapy

Incidence, risk factors, and outcome of advanced NSCLC patients receiving antiangiogenic therapy with thromboembolic events: a retrospective cohort study

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